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Injury Forms

Injury Forms - Non-Public Safety

  • Instructions for reporting work related injuries
    • Directions to Occupational Health Center
    • Sample Occupational Health notice
    • Form 118
    • Form 101
    • Medical Authorization form

Injury Forms - Public Safety

Injury Forms - School

  • Instructions/Protocol for reporting work related injuries
    • Directions to Occupational Health Center
    • Sample Occupational Health notice
    • Form 118
    • Form 101
    • Medical Authorization form
 
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Office of the Mayor
City of Haverhill, Massachusetts
City Hall, Room 100, 4 Summer Street, Haverhill, MA 01830
mayor@cityofhaverhill.com
978-374-2300

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